The role of nutrition in the development of esophageal cancer: What do we know?

Cancer of the esophagus is the eighth most common cancer by incidence worldwide and ranks sixth as the most common cause of cancer death. It is unique among the gastrointestinal tract malignancies because it embodies two distinct histopatologic types, squamous cell carcinoma and adenocarcinoma. Which type of cancer occurs in a given patient or predominates in a given geographic area depends on many variables, including individual lifestyle, socioeconomic pressures, environmental factors and diet and nutrition. Generally for both squamous cell carcinoma and adenocarcinoma of the esophagus case-control studies provide evidence of a protective effect of fruits and vegetables. Here we review the role of nutrition in the etiology of esophageal cancer

Normothermic frozen elephant trunk: our experience and literature review

none6Background and Objective: The frozen elephant trunk (FET) technique has undoubtable advantages in treating complex and extensive disease of the aortic arch and the thoracic descending aorta. Despite several improvements in cardiopulmonary bypass conduction and surgical strategy, operative times and the institution of systemic circulatory arrest remain the main determinants of early mortality, cerebral/spinal cord injury and visceral organs dysfunction. We have conducted this review to highlight the recent technical advances in arch and FET surgery aiming at the reduction/avoidance of systemic circulatory arrest, and their impact on early outcomes. Methods: A literature search (from origin to January 2022), limited to publications in English, was performed on online platforms and database (PubMed, Google, ResearchGate). After a further review of associated or similar papers, we found 4 experiences, described by 11 peer-reviewed published papers, which focused on minimising or avoiding systemic circulatory arrest during total arch replacement plus stenting of the descending thoracic aorta. Key Content and Findings: Recent experiences reported the use of an antegrade endoaortic balloon, advanced and inflated into the stent graft, to provide an early systemic reperfusion soon after the deployment of the stented portion of the FET prosthesis and minimize the circulatory arrest time (down to a mean of 5 minutes), thus avoiding the need of moderate or deep hypothermia (mean systemic temperature 28-30 ???) while allowing a complete arch and FET repair. Our approach, based on off-pump retrograde vascular stent graft deployment in distal arch/descending thoracic aorta, and the use of a retrograde endoballoon, allows the repair of extensive aortic pathologies during uninterrupted normothermic cerebral and lower body perfusion. Conclusions: The use of endoballoon occlusion has emerged in recent years as a safe and effective strategy to allow distal perfusion during FET repair. This technique minimizes or avoids the detrimental effects of hypothermia and systemic circulatory arrest and significantly reduces the operative times.Malvindi, PG; Alfonsi, J; Berretta, P; Cefarelli, M; Gatta, E; Di Eusanio, MMalvindi, Pg; Alfonsi, J; Berretta, P; Cefarelli, M; Gatta, E; Di Eusanio,

The Evolving Role of Local Treatments for HCC in the Third Millennium

Hepatocellular carcinoma (HCC) represents the fifth most common malignancy and the third cancer-related cause of death worldwide. The aim of this review was to clarify the role of local treatments for HCC, analyzing the indications and defining future perspectives

Prognostic role of endocarditis in isolated tricuspid valve surgery. A propensity-weighted study

Objectives: The role of the underlying etiology in isolated tricuspid valve surgery has not been investigated extensively in current literature. Aim of this study was to analyse outcomes of patients undergoing surgery due to endocarditis compared to other pathologies. Methods: The SURTRI study is a multicenter study enrolling adult patients who underwent isolated tricuspid valve surgery (n = 406, 55 ± 16 y.o.; 56% female) at 13 international sites. Propensity weighted analysis was performed to compare groups (IE group n = 107 vs Not-IE group n = 299). Results: No difference was found regarding the 30-day mortality (Group IE: 2.8% vs Group Not-IE = 6.8%; OR = 0.45) and major adverse events. Weighted cumulative incidence of cardiac death was significantly higher for patients with endocarditis (p = 0.01). The composite endpoint of cardiac death and reoperation at 6 years was reduced in the Group IE (63.2 ± 6.8% vs 78.9 ± 3.1%; p = 0.022). Repair strategy resulted in an increased late survival even in IE cases. Conclusions: Data from SURTRI study report acceptable 30-day results but significantly reduced late survival in the setting of endocarditis of the tricuspid valve. Multi-disciplinary approach, repair strategy and earlier treatment may improve outcomes. Keywords: Endocarditis; Isolated tricuspid valve disease; Tricuspid valve

Coffee consumption is not associated with ovarian cancer risk : a dose-response meta-analysis of prospective cohort studies

Background: Coffee consumption has been associated with numerous cancers, but evidence on ovarian cancer risk is controversial. Therefore, we performed a meta-analysis on prospective cohort studies in order to review the evidence on coffee consumption and risk of ovarian cancer. Methods: Studies were identified through searching the PubMed and MEDLINE databases up to March 2017. Risk estimates were retrieved from the studies, and dose-response analysis was modelled by using restricted cubic splines. Additionally, a stratified analysis by menopausal status was performed. Results: A total of 8 studies were eligible for the dose-response meta-analysis. Studies included in the analysis comprised 787,076 participants and 3,541 ovarian cancer cases. The results showed that coffee intake was not associated with ovarian cancer risk (RR = 1.06, 95% CI: 0.89, 1.26). Stratified and subgroup analysis showed consisted results. Conclusions: This comprehensive meta-analysis did not find evidence of an association between the consumption of coffee and risk of ovarian cancer

Emerging trends in consuming behaviours for non-controlled substances by Italian urban youth: a cross sectional study

Introduction. We investigated legal recreational substances use in a cross sectional study on urban Italian adolescents and young adults, the reasons for consumption and risk perception as function of age, the relation with lifestyles and finally risk factors associated. Methods. The survey methodology involved the administration of an anonymous questionnaire. It consisted of 68 questions, divided into five sections: personal details, socioeconomic characteristics, family and peer group, free time and lifestyles, and substances use. Results. A total of 2621 adolescents and young adults (14-35 years old) from seven different Italian cities. The substances examined were mainly used recreationally (alcohol, energy drinks and smart-drugs) or to improve physical and sexual performance (physical performance-enhancing drugs, anabolic steroids and male sexual enhancement). The knowledge of the health related harm arising from the use of these products was very high for alcohol (>90%), high for smart-drugs (>70%), but significantly lower for anabolic steroids, drugs for sexual enhancement (~60%), physical performance-enhancing drugs or energy drinks (~55%). The principal risks factors for consumption were: the influence of friends (OR:8.8), attending recreational places (OR:5.4) aged between 25-35 years (OR:3.0), be male (OR:2.5) and having a bad relationship with the mother (OR:2.1). Conclusions. These results have implication for prevention and early intervention programs of new legal recreational substance use, which similarly to what is frequently advised for classical illicit drugs should focus on information campaigns and awareness initiatives especially addressed to young male adults who go clubbing, live outside the family and showed closed links with peers.

Riflessioni su una nuova prospettiva: la cattedra mista

The aim of this article is to offer an help in understanding the difficult aspects involved in being a special education needs teacher in the Italian School, by a proposal that starts from examining this role’s weak points and go as far as thinking about a different upskill for the professional resources working for inclusion. If the bill C2444, promoted from the federation FISH and FAND, wants to relaunch the school inclusion by creating separate careers for special education needs teachers, then the here proposed theory is determined to reverse this view, considered as “non-inclusive”. The authors of this article think that if a teacher could teach a subject in part of his time and teach as special education teacher in the other part, he could be a positive change agent for all his students.The aim of this article is to offer an help in understanding the difficult aspects involved in being a special education needs teacher in the Italian School, by a proposal that starts from examining this role’s weak points and go as far as thinking about a different upskill for the professional resources working for inclusion. If the bill C2444, promoted from the federation FISH and FAND, wants to relaunch the school inclusion by creating separate careers for special education needs teachers, then the here proposed theory is determined to reverse this view, considered as “non-inclusive”. The authors of this article think that if a teacher could teach a subject in part of his time and teach as special education teacher in the other part, he could be a positive change agent for all his students

Aortic Root Replacement With Biological Valved Conduits

none9The execution of Bentall procedures using biological valved conduits is expanding owing to the increased incidence of aortic valve and root diseases in the aging population. To review the available data, a systematic search identified 29 studies with a total of 3,298 patients. Although evidence on short-term results suggested favorable outcomes after biological Bentall operations, data beyond 5 years are limited and highlight the urgent need for further investigations with longer follow-up.openCastrovinci, Sebastiano; Tian, David H; Murana, Giacomo; Cefarelli, Mariano; Berretta, Paolo; Alfonsi, Jacopo; Yan, Tristan D; Di Bartolomeo, Roberto; Di Eusanio, MarcoCastrovinci, Sebastiano; Tian, David H; Murana, Giacomo; Cefarelli, Mariano; Berretta, Paolo; Alfonsi, Jacopo; Yan, Tristan D; Di Bartolomeo, Roberto; Di Eusanio, Marc

Molecular Insights and Clinical Outcomes of Drugs of Abuse Adulteration: New Trends and New Psychoactive Substances

Adulteration is a well-known practice of drug manufacturers at different stages of drug production. The intentional addition of active ingredients to adulterate the primary drug may enhance or mask pharmacological effects or may produce more potent drugs to increase the number of available doses and the dealer\u27s profit. Adulterants found in different drugs change over time in response to different factors. A systematic literature search in PubMed and Scopus databases and official international organizations\u27 websites according to PRISMA guidelines was performed. A total of 724 studies were initially screened, with 145 articles from PubMed and 462 from Scopus excluded according to the criteria described in the Method Section. The remaining 117 records were further assessed for eligibility to exclude articles without sufficient data. Finally, 79 studies were classified as non-biological (n = 35) or biological (n = 35 case reports; n = 9 case series) according to the samples investigated. Although the seized samples analyses revealed the presence of well-established adulterants such as levamisole for cocaine or paracetamol/acetaminophen for heroin, the reported data disclosed new adulteration practices, such as the use of NPS as cutting agents for classic drugs of abuse and other NPS. For example, heroin adulterated with synthetic cannabinoids or cocaine adulterated with fentanyl/fentalogues raised particular concern. Notably, adulterants play a role in some adverse effects commonly associated with the primary drug, such as levamisole-adulterated cocaine that may induce vasculitis via an autoimmune process. It is essential to constantly monitor adulterants due to their changing availability that may threaten drug consumers\u27 health

Biological and clinical markers in colorectal cancer: state of the art.

Colorectal cancer (CRC) is the World's third most common cancer. Its prognosis is closely related to the disease stage at the time of diagnosis. Here we review the role of clinical biomarkers (tissue, serum, and faecal) in the management of CRC. Molecular studies have recently widened the opportunity for testing new possible markers, but actually, only few markers can be recommended for practical use in clinic. In the next future the hope is to have a complete panel of clinical biomarkers to use in every setting of CRC disease, and at the same time: 1) to receive information about prognostic significance by their expression and 2) to be oriented in the choice of the adequate treatment